Anti-MDA5 antibody-positive rapidly progressive interstitial lung disease after allogeneic hematopoietic cell transplantation successfully treated with triple immunosuppressive therapy

  • NAKAMURA Yuhei
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • KAWAMURA Shunto
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • MATSUMI Shimpei
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • MATSUMOTO Kazuhisa
    Department of Respiratory Surgery, Kyoto University School of Medicine
  • TANAKA Satona
    Department of Respiratory Surgery, Kyoto University School of Medicine
  • ISHIKAWA Takuto
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • MATSUOKA Akari
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • MENO Tomohiro
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • KAWAMURA Masakatsu
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • TAKESHITA Junko
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • YOSHINO Nozomu
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • YOSHIMURA Kazuki
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • MISAKI Yukiko
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • GOMYO Ayumi
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • OKADA Yosuke
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • TAMAKI Masaharu
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • KUSUDA Machiko
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • AKAHOSHI Yu
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • KAMEDA Kazuaki
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • WADA Hidenori
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • KIMURA Shun-ichi
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • NAKASONE Hideki
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • KAKO Shinichi
    Division of Hematology, Jichi Medical University Saitama Medical Center
  • DATE Hiroshi
    Department of Respiratory Surgery, Kyoto University School of Medicine
  • KANDA Yoshinobu
    Division of Hematology, Jichi Medical University Saitama Medical Center

Bibliographic Information

Other Title
  • 同種造血幹細胞移植後の抗MDA5抗体陽性急速進行性間質性肺疾患に有効であった3剤併用免疫抑制療法

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Abstract

<p>A 34-year-old man with KMT2A-MLLT1 acute myeloid leukemia in first complete remission underwent allogeneic peripheral blood stem cell transplantation from his HLA-matched sister after conditioning with busulfan/cyclophosphamide. He did not have severe graft-versus-host disease, but he developed interstitial pneumonia six months after transplantation when his oral cyclosporine A (CsA) dose was reduced to 10 mg/day. He was given prednisolone (PSL), which temporarily improved his respiratory condition, but he quickly deteriorated when PSL was reduced. Anti-MDA5 antibody was found to be positive after additional testing, and a three-drug combination of intravenous cyclophosphamide+PSL+CsA was initiated for anti-MDA5 antibody positive rapidly progressive interstitial lung disease, which was effective for interstitial pneumonia. He received a successful living-donor lung transplant from his younger brother and sister. We present a case of rapidly progressive anti-MDA5 antibody positive interstitial lung disease in which the patient’s respiratory condition improved after triple therapy and subsequent living-donor lung transplantation.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 64 (4), 250-254, 2023

    The Japanese Society of Hematology

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